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[Complications of vaginal hysterectomy on non-prolapsed uterus]
I Grosdemouge1, V Bléret-Mattart, P von Theobald
1Clinique de Gynécologie-Obstétrique et de la Reproduction Humaine, CHU Clémenceau, 14030 Caen Cedex.
Objective:
To assess our rate of complications after vaginal hysterectomy and those described in the literature, particularly in high risk groups such as obese, nulliparous women with previous abdomino-pelvic surgery or after GnRH administration.
Method:
We retrospectively looked for complications in 490 patients who underwent vagina l hysterectomy between 1990 and 1998: infections, hemorrhage, intraoperative complications, thrombophlebitis or pulmonary embolism, postoperative complications up to one month. The chi-squared test, t test for equality of means and Fisher's exact test were used for statistical analysis.
Results:
The complication rate observed in our series (20.7%) was similar to those reported in the literature. We found no difference in the obese group (n=109) the nulliparous women (n=34), after GnRH administration (n=24) or i women with previous abdomino-pelvic surgery (n=128). Heavy bleeding was not increased by morcellation.
Conclusion:
Vaginal hysterectomy is easy and safe. The vaginal route is the best way for obese subjects and can be carried out in most cases, especially in nulliparous women or after GnRH analogs, even when morcellation is necessary, without increasing morbidity.